Restoration of innate host defense responses by oral supplementation of branched-chain amino acids in decompensated cirrhotic patients.

Aim: It has been reported that host defense responses, such as phagocytic function of neutrophils and natural killer (NK) cell activity of lymphocytes, are impaired in cirrhotic patients. The aim of the present study was to examine the effects of oral supplementation of branched-chain amino acids (BCAA) on host defense mechanisms in peripheral blood of patients with decompensated cirrhosis.

Methods: Ten patients with decompensated cirrhosis received 12 g BCAA daily for 3 months.

Exaggerated ambulatory blood pressure variability is associated with cognitive dysfunction in the very elderly and quality of life in the younger elderly.

Background: It is reported that blood pressure (BP) variability increases with aging, and cognitive dysfunction may be related to BP variability; however, there are no data showing that exaggerated BP variability is associated with cognitive dysfunction or quality of life (QOL) in the older elderly. We investigated the relationships and the differences between ambulatory BP variability and cognitive function or QOL in younger elderly and very elderly.

Methods: We recruited both 101 very elderly (aged > or =80 years) and 101 younger elderly (aged 61 to 79 years).

Hepatocellular carcinoma with direct invasion to the stomach.

A 71-year-old man was admitted to our hospital with abdominal pain. Hepatocellular carcinoma (HCC) had been diagnosed 2 years earlier and he had undergone 7 courses of intra-hepato-arterial chemotherapy (IHAC). We performed gastrointestinal fiberscopy and identified a massive protrusion on the lesser curvature.

[Recent advances and limitations of medical treatment on heart failure].

Main part of the management of chronic heart failure is pharmaceutical therapy. In patients with chronic heart failure due to left ventricular systolic dysfunction, enhanced activation of neurohormonal systems including sympathetic nerve and renin-angiotensin-aldosterone system plays the most important role in its progression and poor prognosis. Therefore, principle of treatment of chronic heart failure is inhibition of the elevated neurohormonal activity.

Comparison of once-daily glargine plus sulfonylurea with twice-daily 70/30 aspart premix in insulin-naive Japanese patients with diabetes.

Background: Type 2 diabetes patients insufficiently controlled with sulfonylurea (SU) are commonly treated by switching to twice-daily premix insulin replacing SU. The efficacy of glargine (GL) added on to SU compared with the premix therapy has not been analyzed in Japan.

Methods: The open-label two-arm study was conducted in 30 type 2 diabetes patients poorly controlled [hemoglobin A(1c) (HbA(1c)) >7.

Type B aortic dissection associated with Salmonella infection.

A 59-year-old man with a long history of hypertension and diabetes was admitted to our hospital with acute type B aortic dissection 14 days after the sudden onset of back pain. The dissecting descending thoracic aorta was enlarged to 5.2 cm in diameter, and laboratory tests showed an elevated white blood cell count (15530/mm3) and an increased C-reactive protein level (19.

Adenocarcinoma arising in a mediastinal enteric cyst.

A 39 year-old male was admitted to our hospital because of relapsing episodes of pneumonia. His chest roentgenogram showed a consolidated shadow and cavity formation in the left lower lobe. During a left lower lobectomy an enteric cyst in the posterior mediastinum involving lung was found.

C4B deficiency associated with membranoproliferative glomerulonephritis.

A 10-year-old girl was noted to have microscopic hematuria and proteinuria in 1986. As her urinary abnormalities were persistent, she underwent a renal biopsy on 4 occasions until 2003. Although the appearances of the renal biopsies were strongly suspicious of systemic lupus erythematosus, she never exhibited specific autoantibodies or distinctive symptoms.

Subcutaneous injection of heparin calcium controls chronic disseminated intravascular coagulation associated with inoperable dissecting aortic aneurysm in an outpatient clinic.

Background: Chronic disseminated intravascular coagulation (DIC) is a rare but critical complication of aortic aneurysm, and can represent a difficult long-term management problem. Although surgical correction is the treatment of choice, alternative therapy is required for inoperable patients.

Results: We report herein a case of acute exacerbation of chronic DIC with inoperable dissecting aortic aneurysm, which was recurrent and resistant to regular treatment.

C-reactive protein induces endothelial cell apoptosis and matrix metalloproteinase-9 production in human mononuclear cells: Implications for the destabilization of atherosclerotic plaque.

C-reactive protein (CRP) has been suggested to directly induce the inflammatory response leading to the progression of atherosclerosis. However, recent in vitro studies raised the possibility that the effects of CRP are caused by biologically active contaminants such as sodium azide and endotoxin. In this study, we tested whether azide- and endotoxin-free CRP induces endothelial cell apoptosis and production of proinflammatory mediators.

SIADH is only an atypical clinical feature in a patient with prolactinoma.

A 50-year-old man was admitted to determine the pathogenesis of hyponatremia. He had a poor appetite and was easily fatigued. Physical findings showed that he was conscious and alert.

A case of hypomyopathic dermatomyositis associated with rapid progressive interstitial pneumonia resistant to multi-immunosuppressive therapy.

The prognosis of interstitial pneumonia in patients with dermatomyositis is thought to depend on the histologic type and response to therapy. We report a case of hypomyopathic dermatomyositis with rapid development of a fatal interstitial pneumonia. Although the histology of lung biopsy indicated minimal alveolitis, the patient died despite multi-immunosuppressive therapy.

Hypoadiponectinemia in patients with cerebral infarction: comparison with other atherosclerotic disorders.

The present study was undertaken to determine serum adiponectin level in patients with cerebral infarction and to further analyze any difference in serum adiponectin levels among atherosclerotic disorders. One hundred fifty-two subjects with atherosclerotic disorders were enrolled, 110 males and 42 females, with the age of 67.0 +/- 9.

Elevation of serum adiponectin and CD146 levels in diabetic nephropathy.

Objective: The present study was undertaken to measure serum levels of adiponectin and CD146, an endothelial cell injury marker, and to clarify the property of adiponectin and CD146 in patients with diabetic nephropathy.

Design: A total of 280 diabetic patients, and 49 control subjects were enrolled. Serum levels of adiponectin and CD146 were measured by ELISA.

Immunohistochemical study of osteopontin and L-selectin in a rat endometriosis model and in human endometriosis.

Objective: To investigate the localization of the proteins osteopontin (OPN) and L-selectin (SELL).

Design: Retrospective nonrandomized immunohistochemical study in a surgically induced rat model of peritoneal endometriosis and in samples of human endometriotic lesions of ovaries.

Setting: Department of gynecology in a university hospital.

Reduction of neointimal hyperplasia after coronary stenting by pioglitazone in nondiabetic patients with metabolic syndrome.

Background: This study investigates whether pioglitazone reduces neointimal hyperplasia after coronary stenting in nondiabetic patients with metabolic syndrome (MS) using intravascular ultrasound (IVUS). Pioglitazone, a novel insulin-sensitizing thiazolidinedione, has been shown to reduce neointimal hyperplasia after coronary stenting in patients with type 2 diabetes. However, the effect of pioglitazone on in-stent restenosis in nondiabetic patients with MS remains unknown.

Posterior spinal shortening for paraparesis following vertebral collapse due to osteoporosis.

Study Design: Retrospective case series.

Objectives: To assess the efficacy of posterior spinal shortening for paraparetic patients following vertebral collapse owing to osteoporosis, especially on instrumentation loosening.

Setting: Department of orthopaedic surgery, Jichi Medical University Hospital and Omiya Medical Center in Japan.

Endobronchial aspergillosis and actinomycosis associated with broncholithiasis.

Endobronchial aspergillosis or actinomycosis associated with broncholithiasis is extremely rare. Here, we describe two cases of endobronchial aspergillosis and actinomycosis associated with broncholithiasis. The patients underwent pulmonary resection due to massive hemoptysis.

Possibly simultaneous primary aldosteronism and preclinical Cushing's syndrome in a patient with double adenomas of right adrenal gland.

We reported a rare case of simultaneous primary aldosteronism and preclinical Cushing's syndrome due to unilateral double adrenocortical adenomas in a 57 year-old woman who had had hypertension for the last 10 years. Abdominal computed tomography showed double tumors in her right adrenal gland. Physical findings revealed simple obesity and hypertension, but no other abnormal findings were detected.

Involvement of epidermal growth factor receptor and downstream molecules in bone and soft tissue tumors.

Correlations among epidermal growth factor receptor (EGFR) gene amplification, mutation, and overexpression/activation of proteins were investigated in 39 cases of bone/soft tissue tumors (BSTTs). By immunohistochemistry, EGFR overexpression was found in 22.6% of sarcomas, but not in benign lesions.